MOVSHOVICH  PC

Family Eye Care Center

Alexander Movshovich, MD

596 Anderson Avenue Suite 101

Cliffside Park, NJ  07010

Telephone 201-943-0022

 

Glaucoma

 

Glaucoma

Causes

Symptoms

Types of Glaucoma

Risk Factors

Diagnosis

Treatment

 

 

What is Glaucoma

 

Glaucoma is a disease that damages the eye’s optic nerve. The optic nerve is connected to the retina — a layer of light-sensitive tissue lining the back of the eye — and is made up of many nerve fibers, like an electric cable is made up of many wires. It is the optic nerve that sends signals from your retina to your brain, where these signals are interpreted as the images you see.

Causes of Glaucoma

 

Glaucoma causes include elevated eye pressure (called intraocular pressure or IOP) due to the eye’s inability to drain fluid efficiently.

 

 

Glaucoma Symptoms

 

Only about half of people who have glaucoma are even aware that they have the condition. When glaucoma develops, usually you don’t have any early symptoms. In this way, glaucoma can steal your sight very gradually.

 

In its early stages, open-angle glaucoma has no obvious signs. As the disease progresses and more damage occurs, blind spots develop in your peripheral (side) vision. These spots may not be noticeable until the optic nerve has become severely damaged — or until detected by an ophthalmologist during a complete exam.

 

 

Types of  Glaucoma

 

Open Angle

In its early stages, open-angle glaucoma has no obvious signs. As the disease progresses and more damage occurs, blind spots develop in your peripheral (side) vision. These spots may not be noticeable until the optic nerve has become severely damaged — or until detected by an ophthalmologist during a complete exam.

 

Closed Angle

People at risk for closed-angle glaucoma (also called narrow-angle or angle-closure glaucoma), where the eye’s drainage angle becomes blocked, usually have no symptoms before the attack, though some early symptoms can include blurred vision, halos, headache or mild eye pain or redness. At the time of a closed-angle glaucoma attack, symptoms include:

 

    Severe eye or brow pain

    Redness of the eye

    Decreased or blurred vision

    Seeing colored rainbows or halos

    Headache

    Nausea

    Vomiting

Glaucoma Risk Factors

 

 Risk factors for glaucoma include:

    •Age

    • Family history of glaucoma

    • African or Hispanic ancestry

    • Farsightedness or nearsightedness

    • Elevated eye pressure

    • Past eye injury

    • Having a thinner central cornea

     (the clear, front part of the eye covering the pupil and colored iris)

    •  Not having eye examinations when they are recommended

    •  Low blood pressure

    • Conditions that affect blood flow, such as migraines, diabetes and

     low blood pressure

 

 

Glaucoma Diagnosis

 

Your ophthalmologist will do the following tests and exams during a comprehensive glaucoma evaluation:

 

Measure the pressure in your eye (tonometry)

Your doctor measures your eye pressure using tonometry.  Testing your eye pressure is an important part of a glaucoma evaluation. A high pressure reading is often the first sign that you have glaucoma.

 

During this test, your eye is numbed with eyedrops. Your doctor uses an instrument called a tonometer to measure eye pressure. The instrument measures how your cornea resists pressure. Normal eye pressure generally ranges between 10 and 21 mm Hg. However, people with normal-tension glaucoma can have damage to their optic nerve and visual field loss even though their eye pressure remains consistently lower than 21 mm Hg.

 

Inspect your eye’s drainage angle (gonioscopy)

Gonioscopy allows your ophthalmologist to get a clear look at the drainage angle to determine the type of glaucoma you may have.

 

Ophthalmoscopy

Inspect your optic nerve (ophthalmoscopy)

Your ophthalmologist inspects your optic nerve for signs of damage using an ophthalmoscope, an instrument that magnifies the interior of the eye. Your pupils will be dilated (widened) with eyedrops to allow your doctor a better view of your optic nerve.

 

Test your side, or peripheral, vision (visual field test)

The visual field test will check for blank spots in your vision. The results of the test show your ophthalmologist if and where blank spots appear in your field of vision — including spots you may not even notice.

 

Measure the thickness of your cornea — the clear window at the front of the eye (pachymetry)

Because the thickness of the cornea can affect eye pressure readings, pachymetry is used to measure corneal thickness. A probe called a pachymeter is gently placed on the cornea to measure its thickness.

Glaucoma Treatment

 

Non-Surgical

Glaucoma medication

Medicated eyedrops are the most common way to treat glaucoma. These medications lower your eye pressure in one of two ways — either by slowing the production of aqueous humor or by improving the flow through the drainage angle.

 

These eyedrops must be taken every day. Just like any other medication, it is important to take your eyedrops regularly as prescribed by your ophthalmologist.

 

Never change or stop taking your medications without talking with your doctor. If you are about to run out of your medication, ask your doctor if you should have it refilled.

 

Glaucoma Treatment-Surgical

 In some patients with glaucoma, surgery is recommended. Glaucoma surgery improves the flow of fluid out of the eye, resulting in lower eye pressure.

 

Laser trabeculoplasty

A surgery called laser trabeculoplasty is often used to treat open-angle glaucoma. There are two types of trabeculoplasty surgery: argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT).

 

During ALT surgery, a laser makes tiny, evenly spaced burns in the trabecular meshwork. The laser does not create new drainage holes, but rather stimulates the drain to function more efficiently.

 

These  informative videos were provided by the EyeSmart Foundation www.eyesmart.org

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